1. Home
  2. Directory
  3. California
  4. Sacramento
  5. Pediatrics
  6. NPI Profile

GRACE SO MD
NPI 1205169117
Pediatrics in Sacramento, CA

Active since September 09, 2009PECOS Enrolled
1625 STOCKTON BLVD STE 106, SACRAMENTO, CA 95816(916) 262-9002 Get Directions Write a Review

NPPES record last updated: December 8, 2023. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Grace So Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

GRACE SO MD (NPI 1205169117) is an individual pediatrics provider in Sacramento, California, licensed in California (A108392) and active in the NPI registry since September 2009. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1205169117
Entity TypeIndividualFemale
Primary Taxonomy208000000X
Provider Legal NameGRACE SOCredential: MD
Location Address1625 STOCKTON BLVD STE 106Sacramento, CA 95816-7098
Mailing AddressPo Box 255228Sacramento, CA 95865-5228
Phone(916) 262-9002
Sole ProprietorNo
Enumeration DateSeptember 9, 2009
Last NPPES UpdateDecember 8, 2023
NPPES CertifiedDecember 8, 2023
✔ NPI 1205169117 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPediatricsAllopathic & Osteopathic Physicians
Taxonomy Code208000000X
License✔ Licensed in CA · A108392
Definition
A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.
1625 STOCKTON BLVD STE 106, Sacramento, CA 95816
Open in Google Maps ↗

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Grace So Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Grace So reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Sutter Valley Medical Foundation
4.4 mi
Multi-Specialty
2700 GATEWAY OAKS DR
Sacramento, CA 95833
  • Reassigned Medicare billing, California enrollment
  • 3,056 clinicians in this Medicare group
NPI 1952327256 (800) 470-0071

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 95816 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$92.61 typical visit price
range $60.44 – $180.85
Typical copayment $23.15 (range $15.11 – $45.21)
Most-billed visit code 99203
Established Patient
$105.95 typical visit price
range $19.88 – $148.15
Typical copayment $26.48 (range $4.97 – $37.03)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 6

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

ALYSSA BUMSTEAD
Physical Therapist
1625 STOCKTON BLVD STE 106
SACRAMENTO, CA 95816
Sacramento County (916) 262-9040
DR. ANDREW MARCOS IMPERIAL ALTIVEROS MD
Pediatrics
1625 STOCKTON BLVD STE 106
SACRAMENTO, CA 95816
Sacramento County (916) 262-9002
DR. GARRETT HAU SHENG M.D.
Pediatrics
1625 STOCKTON BLVD STE 106
SACRAMENTO, CA 95816
Sacramento County (916) 262-9002
SIMRAN BEHNIWAL
Pediatrics
1625 STOCKTON BLVD STE 106
SACRAMENTO, CA 95816
Sacramento County (916) 262-9002
STACY KIRK HELLIKER NP
Nurse Practitioner (Family)
1625 STOCKTON BLVD STE 106
SACRAMENTO, CA 95816
Sacramento County (916) 262-9108
DR. MICHELE A EVANS MD, MHS
Pediatrics
1625 STOCKTON BLVD STE 106
SACRAMENTO, CA 95816
Sacramento County (916) 262-9108

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Grace So's NPI number?

The NPI number for Grace So is 1205169117. It was assigned to this individual provider in the NPPES registry on September 9, 2009.

Where is Grace So located?

Grace So practices at 1625 Stockton Blvd Ste 106, Sacramento, CA 95816. The listed phone number is (916) 262-9002.

What is Grace So's specialty?

The primary specialty registered for this NPI is Pediatrics with taxonomy code 208000000X.

Is Grace So enrolled in Medicare?

Yes. Grace So is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Grace So's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Grace So reassigns Medicare benefits to Sutter Valley Medical Foundation (Sacramento, CA). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Grace So's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Grace So was last updated on December 8, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.